Treatment
- parotitis prophylaxis is important the principles are:
- adequate fluid intake
- avoidance of anti-cholinergics
- good oral hygiene, i.e. frequent gargles, mouth irrigation, other mouth cleansing and moistening measures
- stimulation of salivary flow by chewing gum may be of benefit
- in acute suppurative parotitis the treatment consists of:
- stringent oral hygiene
- key in the treatment of acute suppurative parotitis (ASP) is rehydration (may require intravenous fluids)
- most cases of ASP due to Staphylococcal aureus, the first drug of choice should be an initial empirical treatment with an antistaphlylococcal penicillin e.g. flucloxacillin, co-amoxiclav. Antibiotic treatment is continued for 10 to 14 days
- if there is failure of medical management then surgery should be considered
- surgical intervention e.g. incision and drainage of the gland, may be indicated if:
- lack of improvement after 3 to 5 days of antibiotic therapy,
- facial nerve involvement,
- involvement of adjacent vital structures (lateral pharyngeal space, deep fascial spaces),
- frank abscess formation within the gland parenchyma
- surgical intervention e.g. incision and drainage of the gland, may be indicated if:
- also there is support for surgical intervention in the form of superficial parotidectomy for patients with ASP in whom chronic recurrent parotitis then develops
Reference:
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